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Boomers' Hepatitis C Test And Denied Insurance Concerns Unwarranted, Experts Say

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Concerned about a positive hep C test affecting your insurance? Don't be, experts say.
Concerned about a positive hep C test affecting your insurance? Don't be, experts say.

Headlines were made last month when the CDC released a draft proposal urging all baby boomers to get tested for hepatitis C, the blood-borne liver disease. Now there's a debate as to whether or not a positive test result for the chronic disease will ruin boomer's chances at receiving insurance, due to the dreaded pre-existing conditions clause insurers often use to deny coverage, MSNBC reports.

A third of people with hepatitis C don't have health insurance, according to a study in the journal Hepatology. Jesse Slome, executive director of the American Association for Long-Term Care Insurance told MSNBC:

“I would never, ever tell anybody to delay getting any kind of medical exam, but you have an advantage over the insurance company if you apply for insurance before undergoing any kind of medical checkups.”

The CDC is also aware of these concerns, said Dr. John Ward, director for the Center's division of viral hepatitis, in a statement. "Considerations regarding insurance coverage are real," Ward said, "affecting individuals and their loved ones..."

With boomers accounting for 2 million of the 3.2 million Americans with the liver disease (which, if untreated, can lead to liver cancer or cirrhosis), the anxiety is understandable; many infected individuals don't even know they have it, but they may be less willing to receive the test if it may lead to being denied for insurance. Yet these concerns are overblown, if not entirely a moot point, some experts say.

"These types of diseases that couldn’t be treated before, people can now get insurance coverage," said Jon Allen, a risk manager at Trumark Financial, a Danville, CA insurance services firm, with knowledge of hepatitis C and insurance claims.

At worst, Allen said, those suffering from really serious cases of the disease may see a higher rate ("maybe two times the standard rate"), but "they’re still insurable," he said. "We’ve had clients who have gone through treatment and [the virus] is virtual undecteable in their bodies. We’ve seen those people get standard-issue policies.

"Most of these people are afraid to tell you anything because they think it’s hard to get insurance," said Allen. "It’s the other way around. The more you’re willing to share with companies [the better]."

The issue may even turn out to be a moot point, said Susan Pisano, a spokeswoman for America's Health Insurance Plans, the industry's trade association. The CDC's call for all boomers to get tested is just in draft form (MSNBC reports that a ruling may be made later this year). "It conflicts with the United States Preventative Services Task Force, which does not recommend that asymptomatic adults get screened," Pisano said. (The USPSTF declined to comment as the proposal is not available yet.) "It is my understanding that at some point they will have an updated recommendation. And that will also be issued in draft."

Another unknown is the contested "Obamacare." The Supreme Court, which is expected to rule on the constitutionality of President Obama's Affordable Care Act this week, may uphold the law that would make it illegal for insurers to deny someone based on a pre-existing condition starting in 2014.

The insurance question shouldn't be strong enough to dissuade people from getting tested though, Allen said. "Hep C is fairly dangerous if you don’t get tested," he said. "I don’t know about worrying about insurance versus my own life."

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